LYME DISEASE AND REMOVAL OF A TICK
PROBLEM
Ticks are vectors for Lyme disease and Rocky Mountain spotted fever. You have been diagnosed with Lyme disease.
CAUSE
Lyme disease is caused by a spirochete from ticks.
PREVENTION
A.Avoid wooded and brushy areas with high grass and leaf litter.
B.Wear light-colored clothes to make ticks easier to spot. Wear long sleeves and tuck pants into the socks to form a barrier. Tumble clothes in a dryer on high heat for 10 minutes to kill ticks on dry clothes after you come indoors.
C.Stick to hiking trails. Avoid contact with overgrown foliage. Ticks prefer dense woods with thick growth of shrubs and small trees as well as along the edge of the woods.
D.Check for ticks after each outdoor activity, especially hairy regions of the body (under arms, in and around ears, belly button, behind knees, between legs, waist and beltline, and hair &and scalp), where ticks often attach. Check for ticks prior to bathing.
E.Bathe or shower as soon as possible after coming indoors to wash off and make it easier to find ticks that are crawling on you.
F.Remove ticks promptly (see instructions that follow).
G.Inspect pets daily and remove ticks when present.
H.Some manufacturers offer permethrin-treated clothing that is effective for. up to 20 washings. This clothing is not recommended for children.
I.Use Environmental Protection Agency (EPA)-registered insect repellents containing DEET, picaridin, IR3535, oil of lemon eucalyptus (OLE), para-menthane-diol (PMD), or 2-undecanone. EPA’s helpful search tool can help you find the product that best suits your needs. Always follow product instructions. The EPA website is available at www.epa.gov/insect-repellents:
a.Do not use insect repellent on babies younger than 2 months old.
b.Do not use products containing OLE or PMD on children under 3 years old.
PRECAUTIONS
A.Do not hold a lighted match or cigarette to the tick. Do not apply gasoline, kerosene, or oil to the tick’s body.
B.Old treatments, including using nail polish and petroleum jelly, should not be used to remove ticks.
TICK REMOVAL
A.Use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible.
B.Wash your hands and the tweezers with soap and water prior to beginning.
C.Grasp the tick with a fine-tip tweezer close to the skin. Remove by gently pulling upward with steady, even pressure without using any twisting motions (see illustrations that follow). If the mouth parts break off and remain in the skin, remove them with the tweezers.
D.If unable to remove the mouth parts easily with clean tweezers, leave it alone and let the skin heal.
E.Clean the bite area and your hands with rubbing alcohol or soap and water.
F.Do not crush or squeeze the tick during removal or with your fingers.
G.Dispose of a live tick by putting it in alcohol, placing it in a sealed bag/container, wrapping it tightly in tape, or flushing it down the toilet.
FIGURE III.6 Grasp the tick’s body close to the skin using a fine-tip tweezer. Avoid squeezing the body.
FIGURE III.7Remove by pulling the tick straight upward without using twisting motions.
TREATMENT PLAN
Activity: As tolerated:
A.After removal, monitor for signs and symptoms of tick-borne disease up to 30 days.
B.If you are prescribed doxycycline, avoid exposure to the sun because a rash may develop.
Diet: Eat a regular diet.
Medications:
A.Acetaminophen or Ibuprofen may be taken for body aches and any fever.
B.Antibiotics are effective against Lyme disease. Most common are doxycycline, amoxicillin, or cefuroxime.
EMERGENT ISSUES/INSTRUCTIONS
A. Go to the hospital for any alteration in mental status, change in behavior, stiff neck, severe headaches, seizure, nausea and vomiting, severe weakness, dizziness, or high fever.
You Have Been Prescribed: ___________________________________________________________
You Need to Take: ___________________________________________________________
Take all of your antibiotics even if you feel better.
You Need to Notify the Office If You Have:
A.No signs of improvement with antibiotic therapy..
B.Red rash that develops, especially if it looks like a target’s bullseye. (See Figure III.8: graphic of bullseye.)
C.Development of a high fever.
D.Other: ___________________________________________________________
Phone: ____________________________
FIGURE III.8Bullseye Target rash.